Normal Anatomy and Physiology of the Female Pelvis

This set of 150 flashcards covers the anatomical structures, muscular supports, vascular supply, and physiological cycles of the female pelvis based on lecture notes.

What are the six external landmarks of the pelvic region?

Mons pubis, labia majora, labia minora, clitoris, urethral opening, and vestibule of the vagina.

How many bones consist of the bony pelvis?

$4$ bones.

Which four bones make up the bony pelvis?

Two innominate bones, the sacrum, and the coccyx.

What three bones fuse to form the innominate bone?

The ilium, ischium, and pubis.

What divides the bony pelvis into the true and false pelves?

An oblique plane that passes through the pelvic brim.

Where is the true pelvis situated in relation to the parietal peritoneum?

It is situated inferior to the caudal portion of the parietal peritoneum.

What is another name for the true pelvis?

The pelvic cavity.

What structures form the posterior wall of the pelvic cavity?

The sacrum and coccyx.

Which muscles form the posterolateral wall of the pelvic cavity?

The piriformis and cocgeus muscles.

What structures form the anterolateral walls of the pelvic cavity?

The hip bones and the obturator internus muscles.

What muscles form the pelvic floor or pelvic diaphragm?

The levator ani and coccygeus muscles.

What is the area located below the pelvic floor called?

The perineum.

What are the three muscles that compose the levator ani?

The pubococcygeus muscles, iliococcygeus muscles, and puborectalis muscles.

Where is the piriformis muscle located in the pelvic cavity?

The posterolateral wall.

Where is the obturator internus muscle located in the pelvic cavity?

The anterolateral wall.

Where is the psoas major muscle located in the pelvic cavity?

The pelvic sidewall.

What occupies the posterior portion of the pelvic cavity?

The rectum, colon, and ileum.

What organs occupy the anterior portion of the pelvic cavity?

The bladder, ureters, ovaries, fallopian tubes, uterus, and vagina.

The abdominal wall muscles extend superiorly from which structure?

The xyphoid process.

The abdominal muscles extend inferiorly to which structure?

The symphysis pubis.

Which paired muscle is found anteriorly on the abdominal wall?

The rectus abdominis muscles.

Which muscles are found anterolaterally on the abdominal wall?

The external obliques, internal obliques, and transversus abdominis muscles.

What muscles are found in the false pelvis?

The psoas major and iliacus muscles.

What muscle is formed by the joining of the psoas and iliacus muscles in the false pelvis?

The iliopsoas muscle.

Where is the apex of the bladder located?

Posterior to the pubic bones.

Where is the base of the bladder located relative to the vagina?

Anterior to the vagina.

Where does the neck of the bladder rest?

On the upper surface of the urogenital diaphragm.

Where do the ureters cross the pelvic inlet?

Anterior to the bifurcation of the common iliac arteries.

What is the position of the ureters relative to the ovaries?

They run posterior to the ovaries.

Under which structure do the ureters coarse anteriorly and medially?

The base of the broad ligament.

By which artery are the ureters crossed at the base of the broad ligament?

The uterine artery.

Where do the ureters enter the bladder?

The posteroinferior bladder.

What is the vagina?

A collapsed muscular tube extending from external genitalia to the cervix of the uterus.

What is the position of the vagina relative to the bladder and urethra?

It lies posterior to the urinary bladder and urethra.

What is the position of the vagina relative to the rectum and anus?

It lies anterior to the rectum and anus.

What is the typical angle between the vagina and the uterine cervix?

$90$ degrees.

What is the approximate length of the vagina?

$9\,cm$.

Along which wall is the vagina the longest?

The posterior wall.

Where does the upper half of the vagina lie?

Above the pelvic floor.

Where does the lower half of the vagina lie?

Within the perineum.

What vessels provide the arterial supply to the vagina?

The vaginal and uterine arteries.

Into which vein does the vagina drain?

The internal iliac vein.

What is the endocervix?

The cervical canal.

How does the endocervix communicate with the uterine cavity?

Via the internal os.

How does the endocervix communicate with the vagina?

Via the external os.

What is the exocervix?

The portion of the cervix continuous with the vagina.

What are the four fornices of the vagina?

Blind recesses formed by the inner surface of the vaginal walls and the outer surface of the cervix.

Which vaginal fornix is deeper than the others?

The posterior fornix.

What are the four divisions of the uterus?

The fundus, body, lower uterine segment (isthmus), and cervix.

Which part of the uterus is the superior portion where fallopian tubes attach?

The fundus.

What is the longest portion and central part of the uterus?

The body.

What is the most inferior part of the uterus that attaches to the vagina?

The cervix.

In what orientation is the uterus normally found?

Anteflexed and anteverted.

What structures support the uterus?

Levator ani muscles, cardinal ligaments, and uterosacral ligaments.

Which ligament holds the uterus in an anteverted position?

The round ligaments.

What is the typical length and width of a premenarchal uterus?

$1.0 - 3.0\,cm$ long by $0.5 - 1.0\,cm$ wide.

What is the typical length and width of a menarchal uterus?

$6.0 - 8.0\,cm$ long by $3.0 - 5.0\,cm$ wide.

How much does multiparity increase uterine size?

By $1.0 - 2.0\,cm$.

What is the typical length and width of a postmenopausal uterus?

$3.5 - 5.5\,cm$ long by $2.0 - 3.0\,cm$ wide.

Where is the body of the uterus located relative to the vesicouterine pouch?

Posterior to the vesicouterine pouch.

Where is the body of the uterus located relative to the rectouterine pouch?

Anterior to the rectouterine pouch (of Douglas).

What is the shape of the uterine cavity in the coronal plane?

Funnel-shaped.

What is the shape of the uterine cavity in the sagittal plane?

Slitlike.

What is the perimetrium?

The serous outer layer of the uterus (serosa).

What is the myometrium?

The muscular middle layer composed of thick smooth muscle and connective tissue.

What is the endometrium?

The inner mucous membrane and glandular portion of the uterine body.

What are the two layers of the endometrium?

The basal layer and the functional layer.

Which layer of the endometrium is permanent and lies over endometrial glands?

The basal layer.

Which layer of the endometrium sloughs off during the menstrual cycle?

The functional layer.

Where does the broad ligament extend?

From the lateral aspect of the uterus to the pelvic sidewall.

What is the mesovarium?

The posterior fold of the broad ligament that encloses the ovary.

What is the mesosalpinx?

The upper fold of the broad ligament that encloses the fallopian tube.

Where do the round ligaments extend?

From the fundus to the anterior pelvic sidewalls.

Which ligament firmly supports the cervix by extending across the pelvic floor laterally?

The cardinal ligament.

Which ligament extends from the uterine isthmus to the sacrum?

The uterosacral ligament.

Which ligament extends from the lateral ovary to the pelvic sidewall?

The suspensory (infundibulopelvic) ligament.

Which ligament extends medially from the ovary to the uterine cornua?

The ovarian ligament.

What does the term 'version' refer to in uterine positioning?

The direction that the cervix is pointing.

What does the term 'flexion' refer to in uterine positioning?

The direction the uterus is pointing.

What is anteversion?

Uterine body tilts anteriorly, forming a $90$-degree (or less) angle with the vagina.

What is retroversion?

Uterine body tilts posteriorly, forming a greater than $90$-degree angle with the vagina.

What is anteflexion?

The uterine body folds forward, possibly touching the cervix.

What is retroflexion?

The uterine body tilts back and touches the cervix.

What is dextroversion?

The uterus is positioned more toward the right.

What is levoversion?

The uterus is positioned more toward the left.

What is the infundibulum of the fallopian tube?

The funnel-shaped lateral tube that projects beyond the broad ligament and has fimbriae.

What are fimbriae?

Finger-like projections at the distal end of the fallopian tube near the ovary.

Which part of the fallopian tube is the widest and where fertilization occurs?

The ampulla.

Which part of the fallopian tube is the hardest and lies lateral to the uterus?

The isthmus.

Which part of the fallopian tube pierces the uterine wall at the cornua?

The interstitial portion.

What is the approximate length of the fallopian tubes?

$12\,cm$.

What vessels supply blood to the fallopian tubes?

Ovarian arteries and veins.

Where are the ovaries located?

In the ovarian fossa.

By what structures is the ovarian fossa bounded?

External iliac vessels, ureter, and obturator nerve.

What is the dual blood supply for the ovaries?

The ovarian artery and the uterine artery.

What is the normal position of ovaries relative to the internal iliac vessels?

Anterior to the internal iliac artery and vein.

What is the normal position of ovaries relative to the external iliac vessels?

Medial to the external iliac artery and vein.

What are the two anatomical layers of the ovary?

The cortex (outer layer) and the medulla (central layer).

What does the ovarian cortex consist of?

Follicles in development covered by the tunica albuginea.

What does the central medulla of the ovary contain?

Connective tissue, blood, nerves, lymphatic vessels, and smooth muscle at the hilum.